Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because theres this concern about medication among pregnant women and their physicians, its important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis, he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

In the 1992 presidential
campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W.
Bush. Bush was considered unbeatable due to foreign policy successes including
the end of the Cold War and routing Saddam Hussein in the first Gulf War. But
Bushs approval ratings, which had been in the 90 percent range, began to dip as
his campaign ignored the economic recession. Clintons campaign manager James
Carvilles now famous campaign slogan, "Its the economy stupid," helped turn
the tide and Bill Clinton became the forty-second American president.

Just like George Bushs 1992
presidential campaign, todays medical community continues to promote the
medical myths associated with cholesterol while ignoring the real cause of
cardiovascular disease, inflammation.

Conventional opinion and
current medical dogma holds that low cholesterol, especially low LDL
cholesterol, reduces the risk and incidence of heart disease and stroke. This
belief is so entrenched in the medical community that the FDA now approves drugs
to prevent heart disease, as it did with Zetia and Vytorin, solely on the
evidence that they lower LDL cholesterol levels. Zetia has never been proven to
reduce heart attacks, strokes or death. Statin drugs help reduce the risk of
heart attack and stroke for those whove already had a cardiac event (one
percent over placebo) but fail to reduce death in women, the elderly, men over
the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The
Archives of Internal Medicine looked at seven trials of statin use in
nearly 43,000 patients, mostly middle-aged men without heart disease. In that
review, statins didnt lower mortality.

Nor did they in a study known
as Prosper, published in The Lancet in 2002, which studied statin use
in people seventy and older. Nor did they in a 2004 review in The Journal of
the American Medical Association, which looked at thirteen studies of
nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of
reason, which became even louder after the recently released Enhance study, the
cholesterol zealots continue to view cardiovascular disease with tunnel vision.
This myopic vision fuels the cholesterol drug war which rages on as each
pharmaceutical company seeks to gain economic gain in the 40 billion dollar a
year lipid lowering drug market.

In an attempt to take on the
cholesterol Goliath, Pfizers Lipitor (10 billion dollars in sales annually),
Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and
Zetia, to form the "super drug" known as Vytorin. Vytorins goal was to lower
LDL cholesterol more than either drug could alone. Zetia lowers blood
cholesterol by blocking the absorption of dietary cholesterol from the
intestines. Zetia used alone is modestly effective in lowering LDL cholesterol
by approximately 17 percent. Zocor alone lowers LDL levels by 36 percentsimilar
to Lipitor.

The hope was that by lowering
LDL to dramatically low levels, Vytorin would do a better job of slowing the
accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce
LDLby a whopping 51 percent (similar to AstraZenecas Crestor).

However, the two-year
"Enhance" trial failed to prove that Vytorin is better than Zocor alone for
slowing plaque accumulation; instead atherosclerosis worsened in those taking
Vytorin.

Merck and Schering-Plough
suppressed this finding for twenty months.

The study results were not
revealed until the two drug companies were pressured into doing so by an article
in The New York Times and a Congressional inquiry. The marketers of
Vytorin said they had nothing to hide. Its hard to believe they werent just a
little reluctant to publish their highly anticipated study. The news that
Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was
clinically inferior (perhaps even dangerous) to generic simvastatin (statin),
costing less than $20 a month, obviously wasnt what stockholders wanted to
hear.

Merck and Schering-Plough are
running full-page ads daily in the Times and Wall Street
Journal, warning people not to be confused by a single study and to
continue taking Vytorin. The advice was backed by the American Heart
Association, which the Times reported receives nearly $2 million a year
from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have
bitten the dust in the last coupe of years as well.

Pfizers trial of its
much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and
lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and
strokes.

Estrogen replacement therapy,
which is known to lower LDL cholesterol levels, failed to reduce the incidence
of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering
isnt the answer for everyone, why do statins help people with existing heart
disease? Dr. James K. Liao of Brigham & Womens Hospital in Cambridge,
Massachusetts, has been investigating this question for over a decade. He
suspects that statins have other biological effects. His research shows that
statin drugs not only block cholesterol, but also an inflammation-generating
enzyme known as rho-kinase.

When Liao reduced the
rho-kinase levels in rats, they didnt get heart disease. "Cholesterol lowering
is not the reason for the benefit of statins," he concludes. Of course, there
are dozens of inflammatory chemicals that play a role in triggering
cardiovascular disease. Diet, health habits, our environment, even our
personality may initiate inflammatory chemicals that perpetuate cardiovascular
disease events.

Ralph Waldo Emerson once said,
"People see only what they are prepared to see." As the evidence about
inflammation and cardiovascular disease rises, will conventional medicine and
the public at large be prepared to see that its not about lowering cholesterol
but in reducing inflammation? Hopefully, "Its the inflammation, stupid," will
become a common slogan in the campaign to fight cardiovascular disease.

Rodger Murphree, D.C., has
been in private practice since 1990. He is the founder of, and past clinic
director for a large integrated medical practice, which was located on the
campus of Brookwood Hospital in Birmingham, Alabama. He is the author of
Treating and Beating Fibromyalgia
and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Wont Tell You,
and Treating and Beating Anxiety and Depression with Orthomolecular
Medicine. He can be reached at www.treatingandbeating.com, by email at
drrodgerm@yahoo.com or 1-205-879-2383.

LIVE LOVE LAUGHEvery day can be filled with meaning. Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?What can you stop doing or do differently to simplify your life and make it more meaningful? What is truly important to you? Do you give some time each week to your true priorities?Why not fill your life with love and laughter whenever you can? There is no greater gift than the gift of loving others. There is nothing wrong with taking some time for self-care too. Love your pet? Love walking out in nature? Make time for your passions and those things that add value to your life. Your body, mind and soul will thank you.Do you have a mission in life?Dream it. Think about it. Talk about it. Commit to it.

For the first time in the history of the Olympic Games, the 2010 Winter Games in Vancouver, Canada, include chiropractic care inside the Olympic Village Polyclinic, a multi-disciplinary facility offering comprehensive healthcare and medical services.

While DCs have historically been included on the Olympic medical staff, this years events mark the first time that DCs from the host country will be treating athletes and officials from around the world directly inside the Polyclinic.

This is an historic event not only for the chiropractic profession, but also the athletes who will now have access to the care that will help them prepare their bodies for competition, states Michael Reed, DC, MS, DACBSP, and team USAs medical director (USOC). These athletes train hard and endure significant physical demands. Sports-focused DCs, along with other members of the sports medicine team, are specially skilled to assist them in reaching peak performance.

Chiropractic care has experienced several major moments in Olympic history, dating back to Leroy Perry, DC, who provided chiropractic care to athletes representing Antigua during the 1976 Games in Montreal, Canada. During the 1980 Winter Olympic Games in Lake Placid, NY, George Goodheart, DC, became the first official chiropractor appointed to the U.S. team.

With each subsequent Olympic Games and Pan American Games, the U.S. teams  along with a growing number of other national teams  have included at least one doctor of chiropractic on their medical staff.

Inclusion inside the Polyclinic is another major milestone for the chiropractic profession, and we are grateful to the host city of Vancouver, the head of medical services at the Polyclinic, Jack Taunton, MD, and to Robert Armitage, DC, who helped make this possible, says USOC Director of Sports Medicine Clinics, Bill Moreau, DC, DACBSP.

Author: Southern California University of Health SciencesSource: Southern California University of Health Sciences. February 24, 2010.Copyright: Southern California University of Health Sciences 2010

A recent survey involving 963 college students indicates the college lifestyle is strongly associated with back pain. Of those surveyed, 38 percent or almost 4 in 10 students reported having suffered from back pain within the previous school year. Interestingly, the strongest associations with back pain in college students were the students either feeling chronically fatigued or being in an emotionally abusive relationship. Thus, survey findings indicated psychosocial factors were highly associated with a students likelihood of suffering from back pain.

The most recent research (Neck Pain Task Force Report of the Bone and Joint Decade 2000-2010, a study sanctioned by the United Nations and the World Health Organization) indicates neck manipulation is a safe and effective form of health care, according to Matt Pagano, DC, chiropractic profession spokesperson.

Respected researcher and epidemiologist J. David Cassidy, DC, PhD, DrMedSc, testified as a key witness last week at the hearings on informed consent before the Connecticut Board of Chiropractic Examiners in Hartford, Conn. Speaking as an expert witness and consultant to the International Chiropractors Association (ICA)and with the support of all chiropractic organizations involved in the process, including the American Chiropractic Association, Association of Chiropractic Colleges, Foundation for Chiropractic Progress, Life West, New York College of Chiropractic, Parker College of Chiropractic, Palmer College of Chiropractic, and the University of Bridgeport College of ChiropracticDr. Cassidy addressed key facts and issues on the basis of the existing science and research record, to which he has been a significant contributor. The objective of his testimony was to bring the discussion from an emotional issue back to science and the objective research record.

The chiropractic profession unequivocally supports a patients right to be informed of the material benefits and risks of any type of health care treatment  not just chiropractic. Legislation or regulatory mandates governing informed consent should apply to all health care providers and all treatments in equal measure. However, a new law, regulation or mandate highlighting one specific treatment by a specific health care profession, which carries with it an extremely rare association and no causal link identified in the research, is simply not good public health policy. It would set an unnecessary precedent for all health care providers, procedures and products that would be virtually impossible to implement, said Pagano.

The existing informed consent standards in Connecticut allow for the best opportunity for shared decision making between a patient and his or her health care provider. Further, the chiropractic organizations participating in the hearing process all believe informed consent is more than a piece of paper; it is a process. It should occur in the context of a discussion between a doctor and a patient, and it should be appropriately documented.

In a finding highly relevant to the issue before the Connecticut Board of Chiropractic Examiners, the Neck Pain Task Force study demonstrated that patients suffering from headache and neck pain are no more likely to suffer from a stroke following a visit to a chiropractor than they are after a visit to a family medical physician. This implies that there are factors involved other than the type of care provided by doctors of chiropractic. Its important to note that millions of patients safely benefit from chiropractic care every yearthey are able to return to their normal activities and enjoy a better quality of life.

Dr. Cassidy was an investigator with the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders. The work of this international task force affirms the safety and benefits of chiropractic care for people with neck paina condition frequently treated by doctors of chiropractic. The Task Force initiated this new population-based, case-control and case-crossover study, which appeared in the Feb. 15, 2008 edition of the journal Spine.

The study, which analyzed nine years worth of data from a population of 110-million person years, concluded that vertebrobasilar artery (VBA) stroke is a very rare event and that the risk of VBA stroke following a visit to a chiropractors office appears to be no different than the risk of VBA stroke following a visit to the office of a primary care medical physician (PCP). The study goes on to say that any observed association between VBA stroke and chiropractic manipulationas well as its apparent association with PCP visitsis likely due to patients with an undiagnosed vertebral artery dissection seeking care for neck pain and headache prior to their stroke.

Over the years, popular media has all too often sensationalized the association between chiropractic cervical manipulation and cerebral vascular accidentseven though the evidence would strongly indicate that this assertion is incorrect. The organizations representing the chiropractic profession believe this most recent evidence should help to dispel any myths on this issue, as well as provide more data to support the safety and effectiveness of chiropractic procedures.

As a profession, doctors of chiropractic remain committed to expanding the research and clinical understanding of VBA injuries, because even one cerebral vascular incident that could have been prevented or detected early is one too many.

A new report indicates U.S. hospitals for many are a potentially deadly place. According to the report, 48,000 patients in 2006 were killed in U.S. hospitals from pneumonia and blood-borne infections acquired during the patients hospital stay. This amounted to approximately $8.1 billion in medical costs. According to researcher Anup Malani, In some cases, relatively healthy people check into the hospital for routine surgery. They develop sepsis because of a lapse in infection control and they can die. Overall, it is estimated that 1.7 million healthcare-associated infections are diagnosed every year in the United States.